Childbirth options other than standard obstetrical care in hospitals are being increasingly sought by American women. The full range of new alternatives is extensive, with the most popular being home birth, birth in a maternity clinic and birth in the hospital, but with minimal obstetric intervention. Despite a recent surge of lay and scientific interest in alternative childbirth styles, very little empirical research has been directed at the social and cultural dimensions of their use. Only sparse and incomplete data exist on the sociocultural distribution of childbirth alternatives, and we have no knowledge of how women actually formulate birthing strategies. The purpose of the proposed research is to describe the decision-making process underlying birthing strategies. The approach is exploratory, with specific attention to be focused on the roles played in decision-making by demographic variables, social networks, beliefs, attitudes and values, ethnicity and socioeconomic status. Data will be gathered through intensive, semi-structured interviews of prenatal clients and San Francisco General Hospital, Children's Hospital, and clients of local lay midwives. Naturalistic observation and supplementary interviewing of birth attendants will provide additional data. Analysis will be both quantitative and qualitative.